6Fuller’s metallic tubeOuter tube bi-valved. The 2 blades when pressed together, help in smooth entry of tube.Inner tube is longer & has a vent for phonationPt phonates by closing main tube openingVent also helps in decannulation of tube

21Metallic Tubes Plastic TubesEasily cleaned without suctionCleaning requires suctionCuff is absentCuff is presentCannot be connected to ventilatorCan be connectedRigid & less comfortable to patientSoft & more comfortableConcomitant radio-therapy is to be avoidedCan be given

66Causes of surgical emphysema after tracheostomyDissection into many tissue planes in neckUse of smaller tracheostomy tubeTight closing of skin incisionExcessive struggling & coughing of pt during extubation

90Tracheostomy IntubationInvasiveNon-invasiveComplications are moreLessCan be kept for > 7 daysShould not be keptPt can speakCannot speakTracheo-bronchial toilet is easyDifficultDecreases dead space by 30-50%Does not

91Disadvantages of TracheostomyAnosmia: no nasal air entryAphonia: avoided by phonatory ventAspiration: avoided by cuffed tubeInability to lift heavy weightInability to perform strenuous exerciseInability to swim